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Takahiro Hiraoka, Kazunori Miyata, Yasuko Nakamura, Takashi Miyai, Miyuki Ogata, Fumiki Okamoto, Tetsuro Oshika; Influences Of Cycloplegia With Topical Atropine On Higher-order Aberrations. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2807.
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It is unknown how cycloplegia with topical atropine affects optical quality of the eye. We conducted this study to investigate the influence of topical atropine on higher-order aberrations (HOAs) in children.
Forty-two eyes of 23 subjects (11 boys and 12 girls) with hyperopia, ranging in age from 3 to 12 years (5.74 ± 2.31, mean ± standard deviation), were enrolled in this study. We evaluated refraction and wavefront aberration before and after cycloplegia with topical instillation of 1% atropine solution for one week. Ocular and corneal HOAs were simultaneously measured. Individual Zernike components up to the sixth order were also analyzed for a 6-mm pupil. These parameters were compared before and after cycloplegia.
Cycloplegia with topical atropine caused a significant hyperopic shift from +1.96 ± 1.49 D to +3.28 ± 1.61 D (P < 0.0001, paired t test). Ocular HOAs significantly increased from 0.284 ± 0.081 to 0.314 ± 0.097 µm for coma-like aberrations (P = 0.0118), from 0.174 ± 0.052 to 0.190 ± 0.070 µm for spherical-like aberrations (P = 0.0198), and from 0.336 ± 0.086 to 0.373 ± 0.103 µm for total HOAs (P = 0.0028). Corneal HOAs did not change after cycloplegia. When ocular and corneal HOAs were compared, corneal HOAs were significantly larger than ocular HOAs before cycloplegia (P < 0.05). As for individual Zernike components, significant changes were found in C31, C40, C51, and C55 after cycloplegia (P < 0.05). The induced changes in C40 were significantly correlated with those in spherical equivalent refraction (Pearson’s correlation coefficient, R=0.399, P=0.0083).
Cycloplegia with atropine significantly increases refractive errors and ocular HOAs in children with hyperopia, resulting in reduction in optical quality of the eye. Physiological tonic accommodation appears to help improve retinal image quality by reducing HOAs as well as refractive errors. Cares must be taken when a long-term treatment with topical atropine is conducted during a sensitive period of visual development.
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